Project Summary/Abstract Of the 31 million adults living in rural regions in the US, 21.6 million are overweight and obese, increasing their risk of cancer and cardiovascular disease. Physical activity can reduce and prevent obesity and the health consequences of obesity. Dissemination and implementation research can address the urgent needs of health promotion and disease prevention by accelerating the translation and adoption of effective evidence-based interventions into practice. Micropolitan communities in rural states are a particular concern as they suffer from greater economic and social disadvantages, including higher poverty and unemployment rates, than either metropolitan or nonmicropolitan rural areas. The Prevention Research Center for Rural Health (PRC-RH), with a focus on obesity, addresses the health challenges of residents of micropolitan and other rural communities in Iowa through a variety of Center activities and resources as well as the implementation of the research project, Active Iowa. PRC-RH Center activities include maintenance of an infrastructure with a focus on translation and communication of PRC-RH research and best practices; training of public health professionals, students and community members; and evaluation of PRC-RH activities. The PRC-RH has vibrant partnerships with the Iowa Department of Public Health, and an active Community Advisory Board. The PRC-RH implementation research project, Active Iowa focuses on translation of Active Ottumwa across Iowa and the neighboring states. Specific Aims include: 1)Translating Active Ottumwa into Active Iowa, guided by the Consolidated Framework for Implementation Research (CFIR), into three clusters of micropolitan communities in Iowa. 2) Rigorously evaluating the implementation and behavioral outcomes of Active Iowa using a randomized cluster stepped-wedge design to a) examine facilitators, barriers, and contextual factors associated with the adoption, implementation, and sustainability of Active Iowa, and b) Evaluate Active Iowa using the Reach Effectiveness Adoption Implementation and Maintenance framework (RE-AIM), applying mixed research methods to evaluate implementation at multiple levels of influence and with multiple stakeholders across clusters;3) Disseminate Active Iowa in Iowa, Nebraska, Missouri, and Kansas (CDC Region G). PRC-RH research and activities will address a major evidence gap by knowledge of how best to translate and evidence-based interventions in the rural Midwest.